when the lower end of the small intestine (jejunum) fills too quickly with undigested food from the stomach. Symptoms of early dumping include nausea, vomiting, bloating, diarrhea, and shortness of breath

• Many patients are anicteric and symptom less
• When symptoms appear they are mild
• Flu like
• Upper respiratory infection
• Low grade fever
• Anorexia is an early symptom
• Often severe
• Later jaundice and dark urine may be present

Hepatitis A
Diagnostics

• Stool for hepatitis A antigen
• Serum hepatitis A virus antibodies

Hepatitis A
Prevention

• Vaccine recommended for high risk groups
• Harvix
• Immune globulin to prevent hepatitis A if given within 2 weeks of exposure

Hepatitis B

Caused by a DNA virus

Hepatitis B

• May be insidious and variable
• Loss of appetite
• Dyspepsia
• Abdominal pain
• General aching
• Malaise and weakness
• Jaundice may or not be evident
• Liver may be tender and enlarged
• Spleen may be enlarged
• Posterior cervical lymph nodes may also be enlarged